One year later, Meritus Medical Center still evolving

A year ago Sunday, Washington County Hospital loaded its patients into ambulances and sent them across town to a brand-new facility and a new era of health care.

The first year of Meritus Medical Center, the new 510,000-square-foot hospital on Medical Campus Road, has been a busy one as staff and patients alike adjust to a new layout, new processes, new technology and growing patient volumes, not to mention a new name and a new chief executive officer.

Not quite four months after Meritus opened its doors, the health system's president and CEO, James P. Hamill, retired, turning over the reins to Joseph P. Ross.

"It's been a real treat for me, as the new CEO, to watch the resiliency and creativity of the work force here at Meritus who really worked hard to get that hospital designed and built, at times in the face of some real barriers, and made the move and they never skipped a beat," Ross said. "As soon as the move was done, they started adjusting."

Among the changes introduced in the new building were all single-patient rooms, near-doubling of the emergency department capacity, new imaging technology, and audio-visual links between operating rooms and other areas of the hospital. The hospital also changed more than 130 care procedures, Meritus Health Vice President for Operations Deborah Addo Samuels has said.

Overall, the shift has gone smoothly, hospital officials said.

"It's been remarkable how well the building has worked and functioned," Ross said.

Some aspects of the new building took some time to get used to, he said.

"With all the private rooms, the patients are further apart, so for our employees to travel from one patient to the next, it's a little more than the old building," Ross said.

It has also taken time for staff to fully appreciate the impact of some of the technology that is incorporated into the building, he said.

For example, the new hospital has bed monitoring technology that causes an alarm to sound when a patient attempts to get out of bed. The devices took some getting used to and were challenging to calibrate, but they have proven very useful for alerting staff when a patient might need help, Ross said.

Other new technology is focused on drug safety, he said. Under the new system, before giving medication, staff must scan bar codes on both the patient and the medication so a computer can confirm the correct medicine is being given at the correct time.

A parking shortage has been one of the less-smooth aspects of the transition, officials have said.

The hospital is in the process of adding an additional 350 parking spaces, Ross said. Due to a wet fall, the construction process for the new parking has been delayed a couple of times, but hospital officials hope to see most of those spots ready for use by the first of the year, he said.

When those new parking areas are complete, the hospital will push employee parking out to the new lots to allow for more patient and visitor parking closer to the building, Meritus spokeswoman Mary Rizk said. As part of that process, there will be 10 more handicapped parking spaces, she said.

When the health system first announced its plans to change its name to Meritus — a word derived from the Latin "meritum," referring to merit or worth — officials explained that they wanted a name that would recognize the depth and breadth of a system that serves an area wider than just Washington County.

Since the move, expanded usage has reflected that vision, Ross said.

After moving to the new facility, Meritus saw a "tremendous explosion" in the volume of patients visiting the emergency department, he said. In trauma services, volume is up almost 50 percent from a year ago, he said.

"The vast majority of that growth is coming from outside of our traditional Washington County-Frederick County area," Ross said.

High emergency department usage has at times forced the hospital to go on "yellow alert," meaning all emergency room beds are full, or "red alert," meaning all telemetry-monitored beds are full.

Shortages of intensive care beds and monitored beds remain a challenge, Ross said. The hospital plans to add monitoring capability to another 24 medical-surgical beds, with a goal of having that conversion complete by mid-January, he said.

The first year at Meritus has also included some shifts in staffing, Rizk said. The number of clinical employees has increased and the number of nonclinical employees has been reduced through attrition, she said.

In addition to settling into the new building and dealing with the growth in volume that came with it, the hospital has also switched to a new payment system, he said.

"For years, we were paid on a volume basis, so the more we did, the more we were paid," Ross explained. "Now, we're paid based upon population, so the revenue is, in essence, fixed during the year."

The new system, known as Total Patient Revenue, gives hospitals more of an incentive to reduce expenses by preventing patients from having to be readmitted. Meritus is one of 10 hospitals in the state operating under the Total Patient Revenue model.

Another change this year has been the introduction of a case management program aimed at helping patients stay healthy and avoid hospitalizations, Ross said. The program targets patients with chronic diseases that, when managed properly, should not require them to be in the hospital, he said.

Case managers help with a variety of problems, Ross said. In one instance, a case manager helped to get an elevator repaired in the building where a patient with congestive heart failure lived, he said.

Meritus has also been working with physicians and the community to get ready for health reform, Ross said. This has included trying to understand what Ross calls the "street-level implications" of the very complex federal legislation, he said.

Together, the changes have made the past year a momentous one for health care in Washington County, beginning the moment the new center opened its doors a year ago today.

"When I look at our 3,200 employees that drove that process, I think they've done something for this region that will serve the region for 100 years," Ross said.